IHHD Virtual Education Programs:

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IHHD Virtual Education Programs Improving EHDI
Systems and Outcomes Evelyn Cherow, MPA,
MA Executive Director Institute for Persons Who
Are Hard of Hearing or Deaf National
University La Jolla, CA NATIONAL EARLY HEARING
DETECTION AND INTERVENTION (EHDI) CONFERENCE
Washington, DC February 2-3, 2006
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Faculty Disclosure Information   In the past 12
months, I have not had a significant financial
interest or other relationship with the
manufacturer(s) of the product(s) or provider(s)
of the service(s) that will be discussed in my
presentation.   This presentation will (not)
include discussion of pharmaceuticals or
devices that have not been approved by the FDA .
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INSTITUTE FOR PERSONS WHO ARE HARD OF HEARING
OR DEAF (IHHD)Established with U.S. Congress
funding 2003/2004

• National University System
• Center for Human Advancement
• La Jolla, CA

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Presentation Objectives

• Learn relevant 2005 policy recommendations of the
  U.S. Department of HHS EHDI Work Group and the
  Surgeon Generals Call to Action to Improve the
  Health and Wellness of Persons with Disabilities
  and implications for EHDI systems locally,
  regionally, and nationally
• Consider the applications of accelerated virtual
  (web-based) educational programming (VEP) for
  enhancing interdisciplinary EHDI program
  delivery, specialist referrals, and dissemination
  of policies and resources

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Presentation Objectives

• Discuss strategies for integrating VEP into state
  systems to
• build an interdisciplinary network with uniform
  evidence-based knowledge core,
• strengthen mentor networks,
• access communication skillbuilding, provide
  mentor and peer support to interdisciplinary
  professionals and families.

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Presentation Objectives

• Address health and education disparities
• Recruit ethnic and racial minorities into key
  EHDI professions.

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Institute for Persons Who Are Hard of Hearing or
Deaf

• Mission
• To reduce barriers to
• effective psychosocial development,
• school,
• workplace, and
• career goal achievement
• for the 28 million children and adults with
  hearing loss and deafness in the United States
  and its territories and
• globally!

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IHHD Goals

• By creating Virtual Education Programs
• Provide accessible, lifelong learning
  opportunities, and
• Disseminate preferred educational, clinical, and
  vocational evidence-based practices for
• personnel who serve, teach, counsel these
  children, adults and their families
• persons with hearing loss or deafness
• families, interested public, healthcare and
  education system program leaders.

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Informed Decisionmaking, Health Literacy,
Improved Outcomesfor Children and Families
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Strategic Planning

• Conducted needs assessment with leaders ?
• US Department of Education
• Rehabilitation Services Administration (RSA)
• National Institute on Disability Rehabilitation
  and Research (NIDRR)
• Fund for Improvement in Post-Secondary Education
  (FIPSE)
• Maternal Child Health Bureau/HRSA
• National Institute on Deafness and Other
  Communication Disorders

• Professionals and consumers across the country

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Strategic Planning

• Reviewed state-of-the-science and art
• Assessed known and new potential curriculum
  developers and teaching faculty
• Drafted curricula for national select peer review
• Disseminated fact sheets announcing programs
  forthcoming and assessed demand
  (interviews/agenda topics) at national
  conferences
• Met with national and intl agencies to
  determine fertile ground for partnerships and
  complementary activity
• Chose subject experts to contribute to curricula
  

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Identified EHDI System Barriers and Solutions

• U.S. Department of HHS Report
• Office of Disability
• May 17, 2005
• Closing the Gaps in Educational
• and Health Care Services for
• Infants and Young Children with Hearing Loss
• Recommendations to Federal Agencies
• Early Hearing Detection and Intervention

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2005 HHS Work Group Recommendations

• Education Recommendation 1
• Support a specialized program within Part C to
  assure that infants and young children identified
  with hearing loss have immediate access to the
  expertise of professionals who are knowledgeable
  about hearing loss.

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2005 HHS Work Group Recommendations

• Education Recommendation 2Support demonstration
  projects that identify and develop the most
  effective methods of informing parents about
  education program options and communication
  approaches that are available for their infants
  and young children with hearing loss.

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2005 HHS Work Group Recommendations

• Education Recommendation 3
• Make sure that all communication approaches and
  educational setting options are presented to
  parents.
• Provide the child with the chosen communication
  approach and educational setting for their child
  regardless of where the family lives.

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2005 HHS Work Group Recommendations

• Education Recommendation 4
• (Health Care Recommendation 3)
• Increase financial support of pre-service and
  in-service training for professionals working
  with infants and young children with hearing loss
  including teachers of the deaf/hard of hearing,
  pediatric audiologists, and speech/language
  pathologists.
• Problem The need for informed and specialized
  health care providers, audiologists,
  speech-language pathologists, and early
  interventionists is critical. There are
  insufficient numbers of these professionals to
  serve the rapidly growing population of infants
  and young children with hearing loss.

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2005 HHS Work Group Recommendations

• Health Care Recommendation 3
• Increase funding for the training of health care
  professionals to meet the current critical
  shortages of qualified professional personnel.

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Identified System Problems

• Aiming for
• Better quality of life and independence by
• Increasing knowledge of professionals and
  consumers
• Increasing access to health care and services

• Surgeon General
• Report
• July 2005
• Call to Action to Improve the Health and Wellness
  of Persons with Disabilities

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Capacity Building and Needed System Change

• Two 2005 HHS Reports?
• Innovative Strategies needed to address
• Personnel shortages
• Lack of evidence-based practices knowledge of
  educational clinical personnel serving infants,
  toddlers, preschool-age children
• (true also for school-age and adult populations
  with hearing loss or deafness)
• Improved informed decision making by families and
  professionals
• Communication options and skillbuilding

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Healthy People 2010 Decade-long US Public Health
Agenda

• Overarching Goal
• To eliminate health disparities among segments of
  the population including differences that occur
  by gender, race or ethnicity, education or
  income, disability, geographic location, or
  sexual orientation.

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Desired Program Outcomes

• Enhancing Knowledge to Improve
• Preferred practices
• Interdisciplinary teaming
• Understanding of specialists findings
• Referrals to specialists for persons who are at
  risk for or are hard of hearing or deaf
• Informed partnerships and decisionmaking
• Recruitment into specialty professions!

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ACCESS GOALS

• Eliminate geographic barriers to learning
• Provide captioning, ASL
• Embrace a broad communication philosophy to
  highlight all options
• Reach urban, rural and remote populations
• Translate into other languages (1st Spanish)
• Form national and international mentor/partner
  networks

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• Population
• Effects
• IHHD aims to ?
• Build infrastructure capacity and improve
  healthcare, educational, and vocational systems
  outcomes
• Grow knowledge for a broad range of professionals
  and related personnel serving the population
• Enhance lifelong health, quality of life ,
  education, employability for target population
  hoh/deaf and
• Create unique career and leadership growth
  opportunities
• for persons with hearing loss or deafness.

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IHHDCreating Linkages

• Mentors
• Models
• Networks
• Partnerships

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Network Building

• Interactive formatting via
• discussion threads and chats with
• Faculty experts
• Family members
• Professionals
• Invited guests
• Peer support
• (professional and consumers)

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IHHD VIRTUAL VIRTUALLY ANYWHERE

• Strategies
• HOW?
• To apply online, telepractice, and distance
  education applications
• WHY?
• To deliver educational curricula, health-related
  information, clinical service consultation
• To provide interactive programs and forums to
  affect networking for local, regional, national,
  international capacity building to serve the
  population

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VEP, Accelerated Learning, Diverse Learning
Formats

• Internet access .the KEY
• Multimedia lectures
• Discussion threads and chats with faculty,
  mentors, peer support, families (Hands and
  Voices), deaf/hoh models/families
• Signed and captioned video
• Journal articles and related readings (cybrary)
• Webliographies
• Telepractices

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Online LearningSloan Consortium Report U.S.,
2004

• In higher education from 1998 to 2003,
• 19 increase in online course enrollments
• From 2003 to 2004, a 34 increase was projected
  2.6 million students.
• Literature on online teaching effectiveness
  reflects similar outcomes on performance measures
  compared with on site offerings

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IHHD Designed Virtual Ongoing Continuing
Education Program Formats

• Multi-media, online survey courses offered
  monthly
• Peer reviewed and developed by national experts
• Each course may be taken singly or in any
  sequence, for greater flexibility and optimal
  learning

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PROFESSIONAL DEVELOPMENT PROGRAM DOMAINI.
Children, Youth, and Family Programs

• Improving Early Hearing Detection and
  Intervention (EHDI) Service Delivery Infants and
  Young Children Ages Birth through Five Years
• Enhancing Educational Outcomes for Children and
  Youth, Ages 5 21
• Sign Language Introductory and Intermediate
  Courses
• Cued Speech

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PROGRAM Improving Early Hearing Detection
Intervention (EHDI) Service Delivery Infants
and Young Children Who Are Hard of Hearing or
Deaf (Ages Birth through 5 Years)

• Target Audiences for Knowledge Building
• Early childhood, special and regular educators
• EHDI coordinators and interdisciplinary personnel
  
• Related professionals (OTs, PTs, psychologists,
  social workers, etc)
• Educational program administrators
• Clinical program administrators
• Nurses
• Physicians
• Paraprofessionals
• Family members
• Others

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IHHD EHDI Program4 Courses

• Course 1 Interdisciplinary Screening,
  Assessment, and Planning
• Course 2 Family-Centered Programming
  Partnering with Families
• Course 3 Facilitating Outcomes Language,
  Learning, Speech and Listening
• Course 4 Quality Indicators for Early
  Intervention and Preschool Programs

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Course 1 Interdisciplinary Screening,
Assessment, and Planning

• Curriculum Developers

• Evelyn Cherow
• Deborah Hayes
• Carla Wood Jackson
• Mark Krumm
• Briseida Northrup
• Christine Yoshinaga-Itano

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EHDI Program in 4 Week-Long UnitsCourse Topics

• Course 1
• Interdisciplinary Screening, Assessment,
  Planning

• Development of Family-Centered, Community-Based
  EHDI Systems
• Newborn Hearing Screening
• Demographics, etiologies, types, degree, related
  disabilities
• Audiologic measures
• Continued Surveillance - Monitoring Hearing
  Status and Change
• Medical/surgical/genetics interdisciplinary
  diagnosis intervention
• Developmental Assessment
• Implant Candidacy/ Habilitation
• Family Choices/ Resources
• Special Considerations for Assessing Diverse
  Populations
• Developing Intervention Plans
• Telepractices in Audiology Assessment and
  Intervention

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Course 2 Family-Centered Programming
Partnering with Families

• Curriculum Developers
• Sheila Doctors
• Carla Wood Jackson
• Noel Matkin
• Briseida Northrup
• Sue Schwartz

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EHDI Program Course Topics

• Principles of the Family-Centered Paradigm
• Supporting Families Following Initial Diagnosis
• Family Choices
• Considerations with Initial Diagnosis
• Impact of Deafness or Hearing Loss on Family Life
• Linking Families to Supports Assistive
  Technology
• Empowering Caregivers to Advocate

• Course 2
• Family-Centered
• Programming

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Course 3 Facilitating Outcomes Language,
Learning, Speech, ListeningCurriculum
Developers

• Dinah Beams
• Kathryn Beauchaine
• Evelyn Cherow
• Sheila Doctors
• Leisha Eiten
• Mellisa Essenburg

• Carla Wood Jackson
• Karen Kirk
• Mark Krumm
• Amy McKonkey Robbins
• Briseida Northrup
• Jeffrey Simmons

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EHDI Program Course 3 Topics

• Obstacles to Communication Development for
  Children Who Are HoH or Deaf
• Language Facilitation Techniques- Spoken and
  Signed
• Amplification and Young Children
• Medical and Surgical Assessment and Interventions
• Facilitating Listening
• Facilitating Learning
• Pre-literacy Skills
• Early Learning Facilitating Caregiver/Parent and
  Child Interactions
• Emergent Literacy Development

• Course 3
• Facilitating Outcomes Learning, Language,
  Speech, and Listening

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Course 4 Quality Indicators for Early
Intervention and Preschool ProgramsCurriculum
Developers

• Karen Anderson
• Arlene Stredler Brown
• Evelyn Cherow
• Sheila Doctors
• Carla Wood Jackson
• Briseida Northrup
• Sue Schwartz
• Linda Thibodeau
• Christine Yoshinaga-Itano

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EHDI Program 1 Course Topics

• Course 4
• Quality Indicators for Early Intervention
  Programming

• Adjustment to Hearing Loss or Deafness
  Families, Students, Professionals
• Role of Communication
• Cognition, Language, and Social/emotional
  Development
• Role Models
• Social Skills Peer Relationships
• Counseling Models and Appropriate Assessment
  Measures
• Advocacy and Self-Advocacy
• Deaf Community and Culture

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Certificate Course Electives

• Sign Language Communication Skills Program
• Ready!Set!Sign!!
• An Online Exclusive
• Introductory Course
• Intermediate Course
• Cued Speech
• In Development

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Faculty Curriculum DevelopersReady, Set, Sign
Courses

• Marty Noretsky, Producer
• Daniel Burch
• Sharon OBrien
• Mary Lou Novitsky

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State of Texas Cohort

• 20 regional specialists and ECI program
  administrators
• EHDI Course Interdisciplinary Screening,
  Assessment ,and Planning
• Faculty Briseida Northrup, AuD, CCC-A
• Callier Center, U of TX-Dallas

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Survey Students Demographic Profile

• Describe your reason(s) for taking this course
  (check all that apply) .
• Please describe your current occupation.
•  Describe your current work setting.
• How many years have you worked in your current
  setting?
• Describe your career or personal experience with
  individuals who are hard of hearing or deaf.
• Which of the following best describes the size of
  the community in which you live?
• What are your expected outcomes from taking this
  course?
• How do you intend to apply the knowledge gained
  in this course?
• Multiple Choice Format
• Sample Questions

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Pre- and Post-AssessmentSurvey Tools

• Prior to your taking the IHHD course for which
  youve enrolled, we are requesting you complete a
  brief survey. Your assessment about your current
  knowledge and experiences pertinent to the IHHD
  course focus is important for assessing our
  course content, online teaching tools, faculty
  effectiveness, and resources as well as for
  future program planning. Please complete the
  following survey in which you will be asked to
  evaluate your knowledge on topics related to the
  course

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Pre- and Post-AssessmentSurvey Tools

• General knowledge and understanding of anatomy
  and physiology of the human auditory and
  vestibular (balance) systems
• Understanding of the types, degrees, and causes
  (etiologies) of hearing loss particularly in
  children
• Understanding of the main reasons why Early
  Hearing Detection and Intervention (EHDI) is
  supported with legislation and regulations as
  well as substantial state and federal funding in
  the US and in other countries of the world

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Pre- and Post-AssessmentSurvey Tools

• Knowledge of the historical perspective of
  clinical and research initiatives that led to the
  establishment of universal newborn hearing
  screening (UNHS/NHS) and EHDI program policy and
  initiatives
• Knowledge of past and current behavioral, risk
  registry, and electrophysiologic (objective)
  approaches to newborn hearing screening e.g.,
  Auditory Brainstem Response and Otoacoustic
  Emissions
• Familiarity with the Joint Committee on Infant
  Hearing-- its evolution, position statements, and
  current JCIH recommendations of principles,
  guidelines, and benchmarks for development of
  comprehensive and accountable EHDI systems

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Pre- and Post-AssessmentSurvey Tools

• Knowledge of the federal mandates and specific
  federal agency initiatives that stimulated state
  EHDI program development and mandates
• Familiarity with the training, expertise, and
  role of individual members of the
  interdisciplinary team providing diagnostic and
  intervention services for infants toddlers and
  their families/caregivers
• Understanding of audiologic screening protocols
  using ABR or OAE procedures and the rationale for
  setting pass or refer criteria for diagnostic
  testing, tracking, and follow up

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Pre- and Post-AssessmentSurvey Tools

• Familiarity with benchmarks and quality
  indicators of EHDI programs and the related
  monitoring of outcomes needed
• Understanding of audiologic evaluation procedures
  for young children at different developmental
  stages
• Understanding of the medical professionals' roles
  in diagnostics, treatment, follow up and the
  monitoring of risk indicators for late onset or
  progressive hearing loss in childhood

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Pre- and Post-AssessmentSurvey Tools

• Understanding of developmental assessment tools,
  methods, and considerations unique for children
  who are hard of hearing or deaf and their
  families
• Understanding of conditions and criteria for
  medical or surgical treatment and/or cochlear
  implantation candidacy
• Awareness of amplification options for young
  children and fitting strategies for hearing aids
  and assistive listening devices
• More questions per course content

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TX EHDI Course 1 January 2006
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TX EHDI Course 1 January 2006
Years Worked in Current Setting
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TX EHDI Course 1 January 2006
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TX EHDI Course 1 January 2006
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TX EHDI Course 1 January 2006
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TX EHDI Course 1 January 2006
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TX EHDI Course 1 January 2006
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The TX IHHD Experience

• We are very happy with the current course
  format. A wonderful secondary effect for our
  Texas ECI professionals taking the course is the
  group dynamic that develops in the course with
  the discussion board interactions on specific
  course topics. Working together (over the
  month-long course) has brought a sense of
  camaraderie and group think thats hard to
  achieve traditionally as were spread across
  Texas.You can feel the pat on the back about
  comments made and ideas suggested
• Cyndie Schmitt
• Program Specialist
• Department of Assistive
• and Rehabilitative Services
• Early Childhood Intervention Services

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Living With Hearing Loss

• Psychosocial Consequences and
• Effective Accommodations

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Sam Trychins Faculty View on Course Launch

• I am impressed with the quality of the
  interactions the students displayed while
  answering questions on the Discussion Board or
  during the weekly chat sessions.
• I particularly liked the way many students
  talked about how they were applying the
  information they learned on the job (and at home
  with relatives who have hearing loss) or
  personally in the cases in which the counselors,
  themselves, have hearing loss and, in some cases,
  cochlear implants.

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Sam Trychins Faculty View

• I also liked the enthusiasm displayed for the
  course content by many of the counselors. I think
  that their grades attest to the fact that they
  were indeed reading/viewing the material 11 of
  the 13 received 90 or better, and the other two
  earned 84 and 89, respectively.

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Sam Trychins Faculty View

• I thought that the ability to respond
  individually to each of the students was an
  advantage over doing a face to face presentation
  to a large group of counselors. Three venues for
  such interfaces were available and used. The
  discussion board Q and A, the weekly chat
  session, and direct email.
• I think it is also of benefit to have the
  students be able to do the requirements at their
  own pace over a four-week period, rather than
  getting hit with such a volume of material in a
  one or two day training workshop. This format
  allows students to digest the information, try
  out procedures and strategies, and get feedback
  on their performance or answers to any questions
  that may remain.

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Sam (contd)

• I have always been aware that the massive
  infusion of information in a brief time-frame has
  limited effectiveness in terms of students
  absorbing the material. But, there was previously
  no efficient way, outside of a college classroom
  experience, to impart the information bit by bit
  over an extended period of time. I am delighted
  with this much more efficient, online format and
  much more pleased with the results than I have
  been in the past .

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IHHD Contact Information

• WWW.IHHD.NU.EDU
• 1-877-532-7606 for
• Extended Learning
• course enrollment
• 1-858-642-8445 for IHHD
• echerow_at_nu.edu